Individual
MR. RANDALL BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
935 MARIETTA ST NW, 29, ATLANTA, GA 30318-0527
(678) 663-8714
Mailing address
935 MARIETTA ST NW, 29, ATLANTA, GA 30318-0527
(678) 663-8714
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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